South Bay Sports and Family Medicine, a Medical Corporation

NPI #1881884310 in Campbell, California

Provider Information

NPI Number: 1881884310
Entity Type: Organization
Organization Name: South Bay Sports and Family Medicine, a Medical Corporation
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Jul 31, 2007
Last Updated: Aug 20, 2008

Practice Location

Address: 221 E HACIENDA AVE
Address 2: SUITE B
City: Campbell
State: California
ZIP Code: 95008-6616
Phone: (408) 376-3350

Authorized Official

Name: CHRISTIAN JAMES FULMER, DO
Title: CEO
Phone: (408) 568-2641

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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